Ambulatory esophageal and hypopharyngeal pH monitoring in patients with hoarseness.
Ten patients referred by an otolaryngologist for ambulatory esophageal pH monitoring for suspected reflux-induced hoarseness were monitored with a dual ambulatory pH system in which probes were simultaneously placed 5 cm above the lower esophageal sphincter and 2 cm above the upper esophageal sphincter (laryngeal inlet). All were nonsmokers. Hypopharyngeal reflux (pH drop less than 4 in upper electrode preceded by pH drop less than 4 in esophageal electrode) was conclusively demonstrated in 7 of 10 patients. Three of these seven patients had normal frequency and duration of esophageal reflux and would have been classified as normal, yet demonstrated acid reflux into the hypopharynx. As a group, these patients were high frequency, short duration, upright refluxers. Combined hypopharyngeal and esophageal pH monitoring is useful in the diagnosis of reflux-induced hoarseness.
Katz
P O
PO
Johns Hopkins University Division of Digestive Diseases, Francis Scott Key Medical Center, Baltimore, Maryland.
D000328:Adult; D000553:Ambulatory Care; D004947:Esophagus; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis*; D006685:Hoarseness / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007013:Hypopharynx; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*